Table 2.

Risk-stratification for Emergency Department (ED) syncope patients.

High risk criteria

Serious condition identified in the ED

History of ventricular arrhythmia

Cardiac device with dysfunction

Exertional syncope

Presentation concerning for acute coronary syndrome

Severe cardiac valve disease (e.g., aortic stenosis < 1 cm2)

Known cardiac ejection faction < 40%

Electrocardiogram findings of QTc > 500 ms, pre-excitation, non-sustained ventricular tachycardia

Emergency physician judgment

Intermediate risk criteria

No high risk features AND

No low risk features AND

Clinical judgment by emergency physician that patient requires further diagnostic evaluation

Low risk

Symptoms consistent with orthostatic or vasovagal syncope

Emergency physician judgment that no further diagnostic evaluation is needed